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Caring for a Growing Elderly Population Is a Growing Problem

How the young will support the old in coming years remains the biggest challenge for the social systems both in the United States and abroad.

According to a recently published USA Today analysis, the United States faces massive costs for Social Security and medical care in the next 70 years. In fact, the pricetag could reach nearly $43 trillion.

And this is an issue for countries around the globe. In Japan, for example, the number of people age 65 and above today is equal to about one-fourth of those in the much wider age range of 15 to 64. As a result, the financial challenge American taxpayers face in supporting older citizens is echoed in many other nations.

Some countries, including Sweden, which is always a leader in social planning, have taken early steps to manage the cost of healthcare and retirement for their aging population. They have retooled retirement plans, tying benefits to contributions, raised retirement ages and increased taxes. Furthermore, they have reined in healthcare costs. Social policies that mirror these in the United States, of course, are part of the growing political debate on domestic issues, but they are overshadowed by the more ominous war-talk in this election.

According to USA Today, only a few countries have other weapons to combat the costs of an aging population. Spain, for example, has relatively few women in the workplace. Adding them to the labor force would increase the number of workers supporting the elderly. Norway uses oil revenue from the North Sea to offset the cost of national healthcare and pensions. Still other countries with low birth rates are urging people to take more vacations and have more children.

Other developed nations are trying a mix of raising taxes, increasing the age at which people start collecting benefits, and requiring individuals to save on their own. Here's what USA Today found they do:

• Delaying retirement age. Some European countries allow retirement at 60 or even earlier. In Italy , for example, people can retire at 57 and collect full benefits if they have worked 35 years. The Italian government is pushing to raise the retirement age but faces opposition from unions.

• Tying benefits to contributions. Many plans abroad base benefits on a percentage of a worker's salary. Wages typically rise faster than inflation, so this method leads to a rapid increase in benefits.

• Paying off other debts. A country with a budget surplus is better equipped to meet its liabilities than one with a large deficit, such as the United States . But when a country runs a large surplus, political pressure mounts to return the surplus to taxpayers. Case in point: Norway , with a budget surplus equaling 12% of its gross domestic product, approved a three-year, $3.5 billion tax cut in 2002.

In all countries, the wild card is the changing cost of healthcare. As populations age, more people need more care, and fewer workers pay into the healthcare system. In some developed nations, “universal health coverage” has been implemented, providing citizens with cradle-to-grave healthcare that is financed by taxes instead of private insurance.

Medical advances have promoted longer, healthier lives with fewer diseases and more treatable illnesses for humans. Long-term care and chronic illnesses are becoming more common, increasing the need for nursing care of a growing elderly population. Nurses in all areas of specialization must be prepared to face these challenges and provide health care in an ethical manner.